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Hepatocellular carcinoma with obstructive jaundice: diagnosis, treatment and prognosis

World Journal of Gastroenterology 2003年第3期9卷 385-391页

作者： Lun-Xin Qin Zhao-You Tang Liver Cancer Institute and Zhongshan hospital, Fudan University, shanghai, China Liver Cancer Institute Fudan University 136 Yi Xue Yuan Road Shanghai 200032 China. zytang@***

Obstructive jaundice as the main clinical feature is uncommon in patients with hepatocellular carcinoma (HCC). Only 1-12 %of HCC patients manifest obstructive jaundice as the initial complaint. Such cases are clinically classified as 'icteric type hepatoma', or 'cholestatic type of HCC'. Identification of this group of patients is important, because surgical treatment may be beneficial. HCC may involve the biliary tract in several different ways: tumor thrombosis, hemobilia,tumor compression, and diffuse tumor infiltration. Bile duct thrombosis (BDT) is one of the main causes for obstructive jaundice, and the previously reported incidence is 1.2-9 %.BDT might be benign, malignant, or a combination of *** thrombi could be blood clots, pus, or *** thrombi could be primary intrabiliary malignant tumors, HCC with invasion to bile ducts, or metastatic cancer with bile duct invasion. the common clinical features of this type of HCC include: high level of serum AFP; history of cholangitis with dilation of intrahepatic bile duct; aggravating jaundice and rapidly developing into liver dysfunction. It is usually difficult to make diagnosis before operation, because of the low incidence rate, ignorant of this disease, and the difficulty for the imaging diagnosis to find the BDT preoperatively. Despite recent remarkable improvements in the imaging tools for diagnosis of HCC, such cases are still incorrectly diagnosed as cholangiocarcinoma or choledocholithiases. Ultrasonography (US) and CT are helpful in showing hepatic tumors and dilated intrahepatic and/or extrahepatic ducts containing dense material corresponding to tumor debris. Direct cholangiography including percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopancreatography (ERCP)remains the standard procedure to delineate the presence and level of biliary obstruction. Magnetic resonance cholangiopancreatography (MRCP) is superior to ERCP in interpreting the cause and

关键词：肝细胞癌梗阻性黄疸合并症肝动脉灌注栓塞化疗诊断临床特点

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the prognostic molecular markers in hepatocellular carcinoma

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World Journal of Gastroenterology 2002年第3期8卷 385-392页

作者： Lun-Xiu Qin Zhao-You Tang,Liver Cancer Institute and Zhongshan hospital,Fudan University,shanghai,China Liver Cancer Institute and Zhongshan hospital Fudan university 136 Yi Xue Yuan Road Shanghai 200032 China.

the prognosis of hepatocellular carcinoma (HCC) still remains dismal, although many advances in its clinical study have been made. It is important for tumor control to identify the factors that predispose patients to death. With new discoveries in cancer biology, the pathological and biological prognostic factors of HCC have been studied quite extensively. Analyzing molecular markers (biomarkers) with prognostic significance is a complementary method. A large number of molecular factors have been shown to associate with the invasiveness of HCC, and have potential prognostic significance. One important aspect is the analysis of molecular markers for the cellular malignancy phenotype. these include alterations in DNA ploidy, cellular proliferation markers (PCNA, Ki-67, Mcm2, MIB1, MIA, and CSE1L/CAS protein), nuclear morphology, the p53 gene and its related molecule MD M2, other cell cycle regulators (cyclin A, cyclin D, cyclin E, cdc2, p27, p73), oncogenes and their receptors (such as ras, c-myc, c-fms, HGF, c-met, and erb-B receptor family members), apoptosis related factors (Fas and FasL), as well as telomerase activity. Another important aspect is the analysis of molecular markers involved in the process of cancer invasion and metastasis. Adhesion molecules (E-cadherin, catenins, serum intercellular adhesion molecule-1, CD44 variants), proteinases involved in the degradation of extracellular matrix (MMP-2, MMP-9, uPA, uPAR, PAI), as well as other molecules have been regarded as biomarkers for the malignant phenotype of HCC, and are related to prognosis and therapeutic outcomes. Tumor angiogenesis is critical to both the growth and metastasis of cancers including HCC, and has drawn much attention in recent years. Many angiogenesis-related markers, such as vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), platelet-derived endothelial cell growth factor (PD-ECGF), thrombospondin (TSP), angiogenin, pleiotrophin, and endostatin (ES) leve

关键词： Apoptosis Carcinogens Carcinoma, Hepatocellular Cell Adhesion Cell Division Cell Nucleus Extracellular Matrix Genes, p53 Humans Liver Neoplasms Neovascularization, Pathologic Ploidies Prognosis Proteome Telomerase Tumor Markers, Biological

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Fully Distributed Cooperative Motion of Group Robots

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Journal of Systems Engineering and Electronics 2002年第2期13卷 28-35页

作者： Dong Shenglong, Chen Weidong & Xi YugengInstitute of Automation, shanghai Jiaotong University, 200030, P.R. China (Received March 9,2001) Institute of Automation Shanghai Iiaotong University 200030 P. R. China

this paper is focused on the fully distibuted cooperative motion of group robots and proposes an approach. Each robots has a local sensing ability and a simple action selection strategy. Computational complexity is decreased by the fully distributed architecture and the information insufficiency is solved by the interaction between the robots and the environment. Variable loop and random method are used to deal with the fluctuation and equity selection problem and the rapidity and reasonability are guaranteed. Some simulations have proved the effectiveness of the proposed approach.

关键词： Biology Iterative methods Probability Sensors

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the prognostic significance of clinical and pathological features in hepatocellular carcinoma

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World Journal of Gastroenterology 2002年第2期8卷 193-199页

作者： Lun-Xiu Qin Zhao-You Tang,Liver Cancer Institute and Zhongshan hospital,Fudan University,shanghai,China Liver Cancer Institute Zhongshan Hospital 136 Yi Xue Yuan Road Shanghai 200032 China.

the prognosis of patients with HCC still remains dismal. the life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, such as patient's general conditions, macroscopic tumor morphology, as well as tumor histopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are worse than the older ones. Co-existing hepatitis status and hepatic functional reserve have been confirmed as risk factors for recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features, such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and advanced pTNM stage, are the best-established risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. Extratumor spreading and lymph nodal metastasis are independent predictors for poor outcome. Some new predictive systems have recently been proposed. Different strategies of treatment might have significant different effects on the patients' prognosis. To date, surgical resection is still the only potentially curative treatment for HCC, including localized postoperative recurrences. Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis

关键词： Age Factors Carcinoma, Hepatocellular Hepatitis Humans Liver Cirrhosis Liver Neoplasms Neoplasm Staging Prognosis Recurrence Sex Factors alpha-Fetoproteins

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Imaging diagnosis of pancreato-biliary diseases: A control study

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World Journal of Gastroenterology 2003年第12期9卷 2824-2827页

作者： Liang Zhong Qiu-Ying Yao Lei Li Jian-Rong Xu Department of Radiology,Renji hospital,shanghai Second Medical University,shanghai 200001,China Department of Radiology Renji Hospital Shanghai Second Medical University Shanghai 200001 China. zhong-liang@***

AIM: To evaluate the clinical value of various imageological methods in diagnosing the pancreato-biliary diseases and to seek the optimal ***: Eighty-two cases of pancreato-biliary diseases confirmed by surgery and pathology were analyzed. there were 38 cases of cholelithiasis, 34 cases of pancreato-biliary tumors and 10 other cases. the imageological methods included B-US, CT, ERCP, PTC, cross-sectional MRI and MR cholangiopancreatography (MRCP).RESULTS: the accuracy rate of MRCP in detecting the location of pancreato-biliary obstruction was 100 %. In differentiating malignant from benign obstruction, the sensitivity of the combination of MRCP and cross-sectional MRI was 82.3 %, the specificity was 93.8 %, and the accuracy rate was 89.0 % . the accuracy rate for determining the nature of obstruction was 87.8 %, which was superior to that of B-US (P=0.0000) and CT (P=0.0330),but there was no significant difference between direct cholangiopancreatography and the combination of MRCP and conventional MRI (P=0.6666).CONCLUSION: In most cases, MRCP can substitute direct cholangiopancreatography for diagnosis. the combination of MRCP and cross-sectional MRI should be considered as an important means in diagnosing the pancreato-biliary diseases, pre-operative assessment and post-operative follow-ups.

关键词：胰胆系疾病影像学诊断胆管阻塞临床研究 B-US ERCP

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Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients

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World Journal of Gastroenterology 2001年第3期7卷 357-362页

作者： Guo Hao Wu Yan Wei Zhang Zhao Han Wu Department of General Surgery.zhongshan hospital,shanghai Medical University.shanghai 200032.China Department of General Surgery Zhongshan Hospital Shanghai Medical University Shanghai 200032China. wughmc@***

AIM: To evaluate if the administration of an enteral diet supplemented with glutamine, arginine and omega-3-fatty acids modulates inflammatory and immune responses after surgery. MEthODS: A prospective randomized double-blind, clinical trial was performed. Forty-eight patients with gastrointestinal cancer were randomized into two groups, one group was given an isocaloric and isonitrogenous standard diet and the other was fed with the supplemented diet with glutamine, arginine and omega-3-fatty acids. Feedings were started within 48 hours after operation, and continued until day 8. All variables were measured before operation and on postoperative day 1 and 8. Immune responses were determined by phagocytosis ability, respiratory burst of polymorphonuclear cells, total lymphocytes lymphocyte subsets, nitric oxide, cytokines concentration, and inflammatory responses by plasma levels of C-reactive protein, prostaglandin E2 level. RESULTS: Tolerance of both formula diets was *** were significant differences in the immunological and inflammatory responses between the two groups. In supplemented group, phagocytosis and respiratory burst after surgery was higher and C-reactive protein level was lower (Pthan in the standard group. the supplemented group had higher levels of nitric oxide, total lymphocytes, T lymphocytes, T-helper cells, and NK cells. Postoperative levels of IL-6 and TNF-alpha were lower in the supplemented group (P this trial that early postoperative enteral feeding is safe in patients who have undergone major operations for gastrointestinal cancer. Supplementation of enteral nutrition with glutamine, arginine, and omega-3-fatty acids positively modulated postsurgical immunosuppressive and inflammatory responses.

关键词： Enteral Nutrition Gastrointestinal Neoplasms Adult Aged Arginine dosage Cytokines Double-Blind Method Enteritis Fatty Acids, Omega-3 Female Glutamine Humans Lymphocyte Count Male Middle Aged Phagocytosis Postoperative Period Prospective Studies Respiratory Burst

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Manipulating the Gut Microbiome to Alleviate Steatotic Liver Disease:Current Progress and Challenges

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Engineering 2024年第9期40卷 51-60页

作者： Ernesto Saenz Nathally Espinosa Montagut Baohong Wang Christoph Stein-thöringer Kaicen Wang Honglei Weng Matthias Ebert Kai Markus Schneider Lanjuan Li Andreas Teufel Division of Hepatology Division of Clinical BioinformaticsDepartment of Medicine IIMedical Faculty MannheimHeidelberg UniversityMannheim 68167Germany Clinical Cooperation Unit Healthy Metabolism Center for Preventive Medicine and Digital HealthMedical Faculty MannheimHeidelberg UniversityMannheim 68167Germany School of Medicine Universidad de Los AndesBogotá111711Colombia State Key Laboratory for Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Internal MedicineⅠ University Clinic Tuebingen&CoE CMFI(Controlling Microbes to Fight Infections)Tuebingen 72074Germany Department of MedicineⅡ Medical Faculty MannheimHeidelberg UniversityMannheim 68167Germany DKFZ Hector Cancer Institute at the University Medical Center Mannheim 69120Germany Molecular Medicine Partnership Unit European Molecular Biology LaboratoryHeidelberg 69117Germany Department of MedicineⅢ University Hospital RWTH AachenAachen 52074Germany

the prevalence of metabolic-dysfunction-associated steatotic liver disease(MASLD)is alarmingly high;it is estimated to affect up to a quarter of the global population,making it the most common liver disorder *** is characterized by excessive hepatic fat accumulation and is commonly associated with comorbidities such as obesity,dyslipidemia,and insulin resistance;however,it can also manifest in lean ***,it is crucial to develop effective therapies for this complex ***,there are no approved medications for MASLD treatment,so there is a pressing need to investigate alternative *** research has characterized MASLD as a multifaceted disease,frequently linked to metabolic disorders that stem from dietary *** suggests that changes in the gut microbiome play a fundamental role in the development and progression of MASLD from simple steatosis to steatohepatitis and even hepatocellular carcinoma(HCC).In this review,we critically examine the literature on the emerging field of gut-microbiota-based therapies for MASLD and metabolicdysfunction-associated steatohepatitis(MASH),including interventions such as fecal microbiota transplantation(FMT),probiotics,prebiotics,short-chain fatty acids,antibiotics,metabolic pathway targeting,and immune checkpoint kinase blockade.

关键词： Microbiome Fecal microbiota transplantation Metabolic-dysfunction-associated steatotic liver disease Fatty liver

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Methionine-dependence and combination chemotherapy on human gastric cancer cells in vitro

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World Journal of Gastroenterology 2002年第2期8卷 230-232页

作者： Wei-Xin Cao Jing-Min Ou Xu-Feng Fei,Department of Clinical Nutrition,shanghai Institute of Digestive Surgery,Ruijin hospital,shanghai Second Medical University,shanghai 200025,China Zheng-Gang Zhu Hao-Ran Yin Min Yan Yan-Zhen Lin,Department of Surgery,shanghai Institute of Digestive Surgery,Ruijin hospital,shanghai Second Medical University,Shangha 200025,China Department of Clinical Nutrition Ruijin Hospital Shanghai Second Medical University 197 Ruijiner Road Shanghai 200025 China. fische@***

AIM: To elucidate whether human primary gastric cancer and gastric mucosa epithelial cells in vitro can grow normally in a methionine (Met) depleted environment, i.e. Met-dependence, and whether Met-depleting status can enhance the killing effect of chemotherapy on gastric cancer cells. MEthODS: Fresh human gastric cancer and mucosal tissues were managed to form monocellular suspensions, which were then cultured in the Met-free but homocysteine-containing (Met(-)Hcy(+)) medium, with different chemotherapeutic drugs. the proliferation of the cells was examined by cell counter, flow cytometry (FCM) and microcytotoxicity assay (MTT). RESULTS: the growth of human primary gastric cancer cells in Met(-)Hcy(+) was suppressed, manifested by the decrease of total cell counts [1.46 +/- 0.42 (x 10(9).L(-1)) in Met(-)Hcy(+) vs 1.64 +/-0.44(x 10(9).L(-1)) in Met(+)Hcy(-), Pthe decline in the percentage of G(0)G(1) phase cells (0.69 +/- 0.24 in Met(-)Hcy(+) vs 0.80 +/- 0.18 in Met(+)Hcy(-), Pthe increase of S cells (0.24 +/- 0.20 in Met(-)Hcy(+) vs 0.17 +/- 0.16 in Met(+)Hcy(-), Pth chemotherapeutic drugs, the number of surviving gastric cancer cells dropped significantly. CONCLUSION: Human primary gastric cancer cells in vitro are Met-dependent; however, gastric mucosal cells have not shown the same characteristics. Met(-)Hcy(+) environment may strengthen the killing effect of chemotherapy on human primary gastric cancer cells.

关键词： Antineoplastic Combined Chemotherapy Protocols Cells, Cultured Culture Media Epithelial Cells Gastric Mucosa Humans Methionine Research Support, Non-U.S. Gov't Stomach Neoplasms

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Cloning,Structural Organization and Chromosomal Mapping of Rat Costimulatory Molecule 4-1BBL

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Acta Biochimica et Biophysica Sinica 2005年第10期37卷 694-701页

作者： Qiu-Ming DONG~1 Li-Jie MA~2 Guang-Bo ZHANG~1 Ya-Fang WU~3 Jia-Yao SHEN~1 Ying CHEN~1 Yong-Jing CHEN~1 Xiang-Ke PU~1 Sai-Yu HANG~1 Xue-Guang ZHANG~(1*) 1 Biotechnology Institute,Soochow University,Suzhou 215007,China 2 Genetics Institute,Fudan University,shanghai 200433,China 3 First affiliated hospital of Soochow University,Suzhou 215006,China Biotechnology Institute Soochow UniversitySuzhou 215007 China Genetics Institute Fudan UniversityShanghai 200433 China First affiliated hospital of Soochow UniversitySuzhou 215006 China

4-1BBL (TNFSF9) is a member of the tumor necrosis factor (TNF) ligand superfamily,whichis expressed on some activated antigen presenting cells and B *** isolated a rat cDNA clone encodingthe rat homologue of the human 4-1BBL (GenBank accession ***259541).the deduced rat 4-IBBLprotein,consisting of 308 amino acids with a molecular weight of 33,469 Da,was a typical type Ⅱtransmembrane glycoprotein,the same as human and routine 4-IBBL.“SDAA” in the cytoplasmic domain ofrat 4-1BBL was deduced to act as the phosphorylation site for casein kinase Ⅰ(“SXXS” motif),which ispresent in the cytoplasmic domains of human and murine 4-1BBL,and all other TNF ligand family membersknown to utilize reverse *** two introns of 4-1BBL were also cloned (GenBank accession ***332409).Rat 4-IBBL is much more homologous with murine 4-1BBL than with human 4-1BBL,in bothnucleotide and amino acid *** 4-1BBL was expressed in all tested tissues:brain,lung,colon,liver,thymus,testicle,kidney,adrenal,stomach,spleen and *** chromosomal location of rat 4-1BBL wasfirst identified by bioinformatics,then by fluorescence in situ hybridization at 9q11(GenBank accessionUni Gene ***.46783).Rat,murine and human 4-1BBL genes are evolved from a common *** and characterization of the rat counterpart of human 4-1BBL will facilitate studies of the biologicalfunction of this molecule.

关键词： TNF superfamily rat 4-1BBL cloning mapping

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Relieving the lower unirary tract symptom in advanced prostate cancer by bipolar plasmakinetic transurethral resection of the prostate

Relieving the lower unirary tract symptom in advanced prosta...

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华东六省一市泌尿外科学术年会暨2011年浙江省泌尿外科、男科学学术年会

作者： Department of Urology,shanghai 9th People' s hospital,shanghai Jiaotong University School of Medicine Mu-jun Lu,Gong-qin Dong,Ke Zhang Min-xi Xu Min Zhang Zhi-kang Cai Yue-qing Jiang Zhong Wang

Objectives:To evaluate the efficacy and safety of bipolar plasmakinetic transurethral resection of the prostate (PKRP) treatment for relieving lower unirary tract symptom(LUTS) in advanced prostate cancer patients. Methods:From August 2007 to June 2010,52 cases of advanced prostate cancer were treated by PKRP for relief LUTS in our ***,bilateral orchiectomy or LHRH agonist and nonsteroidal antiandrogen

关键词： Relieving the lower unirary tract symptom in advanced prostate cancer by bipolar plasmakinetic transurethral resection of the prostate

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